HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 4/11/19 Permit Number:
•
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT TYPE: Garage Door Replacement
PROPOSED IMPROVEMENT LOCATION:
Address: 7590 Gullotti Place, Port St. Lucie, FL 34952
Property Tax ID#: 3414-501-1112-050-8 Lot No. 12
Site Plan Name: NIA Block No. 3
Project Name: N/A
DETAILED DESCRIPTION OF WORK:
Remove and replace 16'X 7'overhead sectional garage door.
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters ✓ Windows/Doors
Electric _Plumbing _Sprinklers _Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ $1,550.00 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name John&Darlene McKinney Name:Kevin R. Matyjaszek
Address:7590 Gullotti Place Company:Excelsior Construction &Roofing
City: Port St. Lucie State:_ Address: 1882 SE Crowberry Drive
Zip Code: 34952 Fax: City: Port St. Lucie State,FL
Phone No.772-344-3513 Zip Code: 34983 Fax: 772-618-6660
E-Mail: Phone No 772-418-8809
Fill in fee simple Title Holder on next page (if different E-Mail info@excelsiorconstruction.net
from the Owner listed above) State or County License CGC 1521911
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: ✓Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans,the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review:room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YODU�R��LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Ft.GlE2�?1liJ /C
Signature of Owner/resee/66ntractor as Agent for Owner Signature of ContractepKicense'flolder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF .0.. Luce COUNTYOF 6e Luc:e
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
thisAL day of Ann 20M by this�lA day of rd 20_Lfby
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Keyllu MCt .�,!3U Kev Malt 1cA
Name of person making st tement. Name of person making stat6riYent.
Personally Known ✓ OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
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"kl 01A AA Iri-)N\,VIA AiD
(Signature of Nota ublic-State of ,g5ljla) (Signature of Notary Publi ate of Flon4`1+bo
�/ $at &, FRANCESV.JOANS .o Bpi FRANCc^S V.J
U 3oo2 -- •••• I YCOMMISSIONMGG 030:8 6 �./ * MYCOMMISSION# G 0038
Commission No. Commission No. '— '✓�6 N
EXPIRES:October29,20 0 r a EX71�4E5:October 9,
OFF��� 9�n�ee ilw?u�9ei Notary$e ' a `OF FI�� W'bec iM�°:Myet '
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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